Potential side effects of radiation therapy of Morbus Dupuytren or Ledderhose

Not unexpectedly, a therapy that destroys or modifies Dupuytren cells also has effects on other cells. A typical side effect is that the irradiated skin dries somewhat. As far as we know, this has no further disadvantages and does not cause any pain, though it might be a longer lasting or permanent effect. In a study covering 13 years of follow-up Betz et al. abstract observed only minor side effects, i.e. skin atrophy and dry desquamation (skin peeling) for 32% of the patients. No radiation burns or cancer were observed.

Nevertheless, it makes sense not to radiate the entire hand but only the Dupuytren's affected area plus the immediate area around it. When using x-rays the rest of the hand should be covered with a lead screening (you can find a picture of a hand with Dupuytren's disease with the irradiated area indicated on our stages page). For safety reasons, the rest of the body should also be protected against radiation. Electron beams can be focussed better and screening of the hand might not be required.

There is a general concern about cancer resulting from high dose x-ray treatments, but the risk depends on dose and energy of the x-rays and on the irradiated parts of the body. We have received statements that for radiation therapy of Morbus Dupuytren/Ledderhose the increased probability of acquiring cancer is negligible and we have not heard of any patients who have developed cancer in irradiated areas. However, as we have not seen anything published on this subject we have calculated this risk and published our results here (cancer_risk_Dupuytren_ radiation). Based on our results we believe that the add-on risk for a lethal cancer is very low, not even measurable. Obviously this is not a definite proof and per se cannot assess the individual case, therefore patients need to decide themselves through consulting with their doctor(s) whether they want to take that risk.

The International Dupuytren Society considers radiotherapy as a very effective, if not the only, means to stop Dupuytren's disease in an early stage and to possibly avoid later surgery. Yet shoukd be aware that not every Dupuytren's patient will experience contractute if untreated and many might never need any treatment.

 



Page last modified: 01/11/2017